I recently asked Steve Mitchinson to contribute an article to the TribeHouse site introducing this unique musical project entitled Giver of Life. It is a collection of songs aimed at bringing hope and comfort to those facing death due to acute illness. Steve Mitchinson is a medical Doctor as well as a fine singer songwriter who was inspired to write these songs through his daily work with those in palliative care. Originally from the UK Steve now resides in Abbotsford British Columbia, Canada. – Graham Ord.

What is it about the end of our lives that scares us so much? Why is it such a taboo subject, one that we have so many euphemisms for, something we whisper about and hide from rather than embrace? What other journey in life would we ever set out upon without at least having some idea about our destination?

We have become adept at avoiding the issues surrounding death and dying to the extent that in the West we don’t even want to look at illness or aging, maybe because those roads lead us to a sense of our own human frailty and the fragility of human life and yes, that there is an end point too. My sense from speaking with others from different cultures and working with them as patients, is that in many cases this avoidance, even of speaking of end of life is no different.

My name is Steve Mitchinson and I am a physician with a background in Family Practice, initially 15 years in the UK and subsequently 6 years in Canada in Mission, BC. I am currently doing a Fellowship year in Palliative Medicine through UBC with a view to spending the rest of my career as a Palliative Physician. I am also a singer/ songwriter and worship leader having had a number of songs published and recorded a couple of CD’s in the last few years. The most recent project is just finished as I write entitled “Giver of life“. This has come about through a recognition that we are missing something important in our approach to life and the end of life, both in our secular society and to some extent in our faith based communities.

In recognition of some of these issues and as a result of finding a paucity of resources for spiritual care available for those approaching end of life and their carers, we started a non-profit society called “The Gracenote Project” www.gracenoteproject.com to bring to the table the resources we could provide and also a vision to begin connecting others working in this area. In musical notation a Gracenote is a short note that comes before the longer note or principle. It has beauty and significance of its own but there is a sense of journey that the melody is going somewhere not an end in itself. Seemed a good metaphor for life so the name of the project came to be.

Having moved to Canada in 2005 , it became clear to me that I was not only responsible for looking after patients in hospital at the end of their lives, but also that coming from a fully office based practice in the UK that I had very little idea how to do this! This set me off on a journey to find some answers and some training. This journey led me to the Victoria Hospice course in 2008 where I found something that resonated with my heart. Little did I know that I was embarking on something that was going to change the course of my career and begin to unite the two sides of my life-the Doctor and the Musician.

A little before this I remember talking with a patient, a man in his mid fifties who was losing a battle with Stomach Cancer. He had surgery and all had looked promising for a time but things had recurred and he was in hospital in the last stages of his illness. We had talked and as so often happens at this stage of life he was asking questions around existential and spiritual issues. I remember stumbling around a bit for answers and thinking “I’ll come back and we can talk some more.” As I know now more clearly-this was a window in time and due to disease progression and medication there never was another really lucid moment for a conversation. I remember thinking what if I could put into song what I would have wanted to say, maybe I could have played it in his room or on headphones. He never did hear the song-but it did get written eventually.

Palliative care by the WHO definition is about care for the whole patient as well as the family and care givers. It is about managing and controlling symptoms and caring for the Physical, Emotional, Psychosocial and Spiritual components of the patients suffering. This complex and challenging task not only requires a multi-disciplinary team to do well, it also requires a wide variety of skills and tools. Music I believe has its part to play in this. Pain (in whatever format it comes) is what happens to the body, suffering is what happens to the person. Music and Song can bring great comfort to those at a time of great need, loss and suffering.

Interesting isn’t it-people generally don’t argue with a song. They may not like the lyrics or even agree with them-but it generally doesn’t start an argument, sometimes they find themselves singing them anyway. Great melodies can stir your heart with powerful emotions and memories. Great songs and music have a way of getting “stuck in your head” in a way the written or spoken word never does. We all have a sound track to our lives and songs that punctuate the journey. It is amazing how patients with advanced dementia can remember and sing words to songs from that soundtrack. We are wired for sound and somehow it speaks a language to our hearts even when conventional language fails.

That first song became a number of songs and eventually a full CD. I am writing from a Faith based perspective, as a Christian, but I wanted to to try and write some songs that would not only bring comfort and hope, but also to help people realize that it’s OK to ask questions. In fact why would we not have questions looking back over our lives and looking forward to somewhere we have never been or done before. Perhaps this has something to say to our concept of “Existential Suffering”- a search for answers in a life full of apparent mystery.

It seems to me that our death denying culture doesn’t allow us the freedom to approach the end of our lives with confidence and preparation. In my experience it seems at times that our faith based communities don’t always do much better. Maybe we don’t have or haven’t been given the language to frame the questions that make our souls sick, or to be able to have the conversations that would help. I believe that music has a significant role to play in giving freedom to our hearts and spirits to search and find comfort, hope and peace. Music has a way of touching and releasing our emotions that goes beyond our abilities to communicate in more conventional ways.

Somehow the resonant frequencies of our hearts can be touched. Music can express our times of joys and our deepest lament and all emotions in between.

I saw a wonderful definition of lament:

” When you are sorrowful, look into your heart and you shall see that you are weeping for that which has been your delight.” Kahlil Gibran

There are clearly times for all types of songs, and times when melody alone is even better as we are not burdened with words that just confuse. I have found music to be immensely helpful in Palliative Care, and it is a journey that I am only really beginning to explore. I look forward to partnering with others, co-working and learning from those who have gone before.

I and the team that are working with me are putting our contribution on the table beginning with our 1st full length CD entitled “Giver of life” It includes songs of hope as well as songs that recognize the turmoil and the questions that legitimately come to the fore in this season of life. I would love to hear from and connect with others working in this area.

In the weeks since we have had the CD available, I have begun sharing the music with people in the Palliative Care community and beginning to communicate with people locally, across Canada and the world. I recently have had dialogue with people running a hospice in Romania about these same issues and helping to resource them. What an amazing privilege.

In closing I recently had a music therapist use the music from Giver of Life independently with a patient I was working with as a physician, truly was an incredible moment for me.

How cool to be able to care for the soul/spirit, the part that lives on as well as the body until it has run its course. It’s more incredible than I really have language for.